Overcrowded emergency departments, staffing shortages, and temporary care measures are leaving doctors increasingly concerned about patient safety as hospitals face a surge in demand.
New findings from a Royal College of Physicians (RCP) snapshot survey of more than 550 doctors reveal a lack of confidence in hospitals’ ability to cope with the coming winter, with just 10% saying they were either very or somewhat confident their hospital can safely manage winter pressures.
NHS hospitals are under significant pressure year-round, but the winter months bring a sharp rise in seasonal illnesses. This seasonal surge compounds existing challenges – such as overcrowded emergency departments, delays for admission, high bed occupancy rates, and delays in discharging patients – placing additional strain on already stretched services.
When asked about their top 3 worries for the winter ahead, physicians most commonly cited limited capacity to provide care, the use of temporary care environments, and staffing shortages, closely followed by risk of burnout. Many (51%) said that they were aware their hospitals plan to open temporary beds to cope, but nearly two in five (39%) said they were unaware of any measures being taken. Nearly half (43%) said they were not confident that current plans will make a positive difference.
The RCP findings come as NHS England releases new performance figures, showing that:
- A&E attendances reached 2.3 million last month
- Over 44,000 patients waited over 12 hours in emergency departments to be admitted
- On average each day, 12,815 people remained in hospital despite being medically fit to be discharged - the busiest September on record.
Together, these NHSE data reiterate a system struggling to keep patients moving through hospitals – with bottlenecks at every stage as emergency departments remain overcrowded, while thousands of patients who are medically fit to leave hospital cannot be discharged.
Without sustained action to reduce avoidable hospital admissions, increase social care capacity, and improve patient flow throughout hospitals, the system risks becoming more overwhelmed than it already is.
Dr Hilary Williams, clinical vice president of the Royal College of Physicians, said:
“It’s concerning to see our physician members tell us that they are not confident their hospitals can safely manage the pressures of the coming winter. We have long-standing, systemic issues in the NHS – from rising A&E attendances to delays in discharge – that cannot be resolved overnight.
“There are practical steps that can be taken now to help ease the burden. Vaccination remains one of the most effective ways to reduce avoidable hospital admissions, particularly for illnesses like influenza and COVID-19. We urge both staff and the public to get vaccinated to help protect themselves and the wider system. At the same time, we need urgent action from government and system leaders to bolster social care and community services including palliative care, improve patient flow, increase bed capacity, and support frontline staff through what is likely to be another extremely difficult winter.”
The RCP’s final snapshot survey of 2025 included questions on winter preparedness, which 552 physicians responded to. The survey was open from Wednesday 3 September to Wednesday 17 September 2025. It was sent via email to clinically active UK members and fellows and promoted on social media.